Maternal human papillomavirus infection during pregnancy and preterm delivery, a mother–child cohort study in Norway and Sweden
Artikel i vetenskaplig tidskrift, 2023
Introduction:
Human papillomavirus (HPV) infection is common in women of reproductive age. Infection and inflammation are leading causes for preterm delivery (PTD), but the role of HPV infection in PTD and prelabor rupture of membranes (PROM) is unclear. We aimed to explore whether HPV infection during pregnancy in general, and high-risk-HPV (HR-HPV) infection specifically, increased the risk of PTD, preterm prelabor rupture of membranes (PPROM), PROM at term, and/or chorioamnionitis.
Material and Methods:
In pregnant women, who were participating in a prospective multicenter cohort study from a general population in Norway and Sweden (PreventADALL, ClinicalTrials.gov NCT02449850), HPV DNA was analyzed in available urine samples at mid-gestation (16–22 weeks) and at delivery, and in the placenta after delivery with Seegene Anyplex II HPV28 PCR assay. The risk of PTD, PPROM, PROM, and chorioamnionitis was analyzed using unadjusted and adjusted logistic regression analyses for any 28 HPV genotypes, including 12 HR-HPV genotypes, compared with HPV-negative women. Further, subgroups of HPV (low-risk/possibly HR-HPV, HR-HPV-non-16 and HR-HPV-16), persistence of HR-HPV from mid-gestation to delivery, HR-HPV-viral load, and presence of multiple HPV infections were analyzed for the obstetric outcomes. Samples for HPV analyses were available from 950 women with singleton pregnancies (mean age 32 years) at mid-gestation and in 753 also at delivery. Results:
At mid-gestation, 40% of women were positive for any HPV and 24% for HR-HPV. Of the 950 included women, 23 had PTD (2.4%), nine had PPROM (0.9%), and six had chorioamnionitis (0.6%). Of the term pregnancies, 25% involved PROM. The frequency of PTD was higher in HR-HPV-positive women (8/231, 3.5%) than in HPV-negative women (13/573, 2.3%) at mid-gestation, but the association was not statistically significant (odds ratio 1.55; 95% confidence interval 0.63–3.78). Neither any HPV nor subgroups of HPV at mid-gestation or delivery, nor persistence of HR-HPV was significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis. No HPV DNA was detected in placentas of women with PTD, PPROM or chorioamnionitis.
Conclusions:
HPV infection during pregnancy was not significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis among women from a general population with a low incidence of adverse obstetric outcomes.
Human papillomavirus (HPV) infection is common in women of reproductive age. Infection and inflammation are leading causes for preterm delivery (PTD), but the role of HPV infection in PTD and prelabor rupture of membranes (PROM) is unclear. We aimed to explore whether HPV infection during pregnancy in general, and high-risk-HPV (HR-HPV) infection specifically, increased the risk of PTD, preterm prelabor rupture of membranes (PPROM), PROM at term, and/or chorioamnionitis.
Material and Methods:
In pregnant women, who were participating in a prospective multicenter cohort study from a general population in Norway and Sweden (PreventADALL, ClinicalTrials.gov NCT02449850), HPV DNA was analyzed in available urine samples at mid-gestation (16–22 weeks) and at delivery, and in the placenta after delivery with Seegene Anyplex II HPV28 PCR assay. The risk of PTD, PPROM, PROM, and chorioamnionitis was analyzed using unadjusted and adjusted logistic regression analyses for any 28 HPV genotypes, including 12 HR-HPV genotypes, compared with HPV-negative women. Further, subgroups of HPV (low-risk/possibly HR-HPV, HR-HPV-non-16 and HR-HPV-16), persistence of HR-HPV from mid-gestation to delivery, HR-HPV-viral load, and presence of multiple HPV infections were analyzed for the obstetric outcomes. Samples for HPV analyses were available from 950 women with singleton pregnancies (mean age 32 years) at mid-gestation and in 753 also at delivery. Results:
At mid-gestation, 40% of women were positive for any HPV and 24% for HR-HPV. Of the 950 included women, 23 had PTD (2.4%), nine had PPROM (0.9%), and six had chorioamnionitis (0.6%). Of the term pregnancies, 25% involved PROM. The frequency of PTD was higher in HR-HPV-positive women (8/231, 3.5%) than in HPV-negative women (13/573, 2.3%) at mid-gestation, but the association was not statistically significant (odds ratio 1.55; 95% confidence interval 0.63–3.78). Neither any HPV nor subgroups of HPV at mid-gestation or delivery, nor persistence of HR-HPV was significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis. No HPV DNA was detected in placentas of women with PTD, PPROM or chorioamnionitis.
Conclusions:
HPV infection during pregnancy was not significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis among women from a general population with a low incidence of adverse obstetric outcomes.
preterm birth
rupture of membranes
HPV
delivery
infections
Författare
Johanna Wiik
Göteborgs universitet
Østfold Hospital
Sahlgrenska universitetssjukhuset
Magdalena R. Værnesbranden
Universitetet i Oslo
Østfold Hospital
Christine M. Jonassen
Østfold Hospital
Norwegian Institute of Public Health
Anne Cathrine Staff
Oslo universitetssykehus
Universitetet i Oslo
Karin C.L. Carlsen
Universitetet i Oslo
Oslo universitetssykehus
Berit Granum
Norwegian Institute of Public Health
Guttorm Haugen
Oslo universitetssykehus
Universitetet i Oslo
Gunilla Hedlin
Karolinska universitetssjukhuset
Karolinska Institutet
Katarina Hilde
Oslo universitetssykehus
Universitetet i Oslo
Bo Jacobsson
Norwegian Institute of Public Health
Göteborgs universitet
Sahlgrenska universitetssjukhuset
Staffan Nilsson
Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik
Göteborgs universitet
Björn Nordlund
Karolinska Institutet
Karolinska universitetssjukhuset
Anbjørg Rangberg
Østfold Hospital
Eva Maria Rehbinder
Universitetet i Oslo
Oslo universitetssykehus
Verena Sengpiel
Sahlgrenska universitetssjukhuset
Göteborgs universitet
Håvard Skjerven
Oslo universitetssykehus
Universitetet i Oslo
Birgitte K. Sundet
Universitetet i Oslo
Oslo universitetssykehus
Cilla Söderhäll
Karolinska universitetssjukhuset
Karolinska Institutet
Riyas Vettukattil
Universitetet i Oslo
Oslo universitetssykehus
Katrine Sjøborg
Østfold Hospital
Acta Obstetricia et Gynecologica Scandinavica
0001-6349 (ISSN) 1600-0412 (eISSN)
Vol. 102 3 344-354Ämneskategorier
Infektionsmedicin
Reproduktionsmedicin och gynekologi
DOI
10.1111/aogs.14509
PubMed
36647213